清热解毒法联合益气养阴法治疗肛周坏死性筋膜炎  

The Method of Clearing Heat and Removing Toxicity Combined with the Method of Benefiting Qi and Nourishing Yin for Perianal Necrotizing Fasciitis

作　　者：宋金忠[1] 葛焱 李青 王书奇[1] 卢瑞云[4] 王丽丽[1] 肖利军[1] SONG Jinzhong;GE Yan;LI Qing;WANG Shuqi;LU Ruiyun;WANG Lili;XIAO Lijun(Department of Anorectal Surgery II,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of Endocrinology,Yiling Hospital of Hebei Province,Shijiazhuang 050000,China;Department of Anorectal Surgery,Xingtai People′s Hospital,Xingtai 054000,China;Department of Gastrointestinal Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院肛肠二科,石家庄050000 [2]河北省以岭医院内分泌科,石家庄050000 [3]邢台市人民医院肛肠外科,邢台054000 [4]河北医科大学第一医院胃肠外科,石家庄050000

出　　处：《世界中医药》2020年第10期1451-1453,1457,共4页World Chinese Medicine

基　　金：河北省中医药管理局2017年度中医药类科研计划课题(2017109)。

摘　　要：目的:探讨清热解毒法联合益气养阴法分阶段治疗肛周坏死性筋膜炎的临床效果。方法:选取2016年7月至2018年4月石家庄市中医院收治的肛周坏死性筋膜炎患者86例作为研究对象,按照随机数字表法随机分为观察组与对照组,每组43例。观察组在对照组治疗基础上加用清热解毒法联合益气养阴法分阶段治疗,比较2组临床疗效、肛周疼痛程度、肛周水肿情况、理化指标及创面愈合时间;对照组给予创面碘伏冲洗+复方黄柏液纱条覆盖。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组肛周水肿轻于对照组,创面愈合时间较对照组短,差异有统计学意义(P<0.05);治疗后,观察组hs-CRP、WBC水平及VAS评分低于对照组,Hb水平较对照组高,差异有统计学意义(P<0.05)。结论:肛周坏死性筋膜炎患者采取清热解毒法联合益气养阴法分阶段治疗疗效确切,可有效减轻患者肛周疼痛及水肿,降低炎性反应,提升Hb水平,促进患者创面愈合。Objective:To explore the clinical effects of methods of clearing heat and removing toxicity combined with benefiting qi and nourishing yin in the treatment of perianal necrotizing fasciitis.Methods:A total of 86 patients with perianal necrotizing fasciitis treated in the Shijiazhuang Hospital of Traditional Chinese Medicine from July 2016 to April 2018 were enrolled and divided into a control group and an observation group according to random number table,with 43 cases in each group.Both groups were given wound iodine flushing plus bandage with compound Phellodendron Liquid;The observation group based on the control group was treated with the methods of clearing heat and removing toxicity combined with benefiting qi and nourishing yin in stages.The clinical therapeutic effects,perianal pain,perianal edema,physical and chemical indicators,and wound healing time in the 2 groups were compared.Results:The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Perianal edema in the observation group was less serious than that in the control group,and the wound healing time was shorter than that in the control group,the difference was statistically significant(P<0.05).After treatment,the levels of hs-CRP,WBC and VAS in the observation group were lower than then control group and the level of Hb higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:For patients with perianal necrotizing fasciitis,the methods of clearing heat and removing toxicity combined with benefiting qi and nourishing yin can help reduce their perianal pain,edema,and inflammation,and increase the Hb level,better for their wound healing.

关 键 词：肛周坏死性筋膜炎 清热解毒法 益气养阴法 分阶段治疗 炎性反应 创面 水肿 疼痛 

分 类 号：R266[医药卫生—中医外科学] R657.1[医药卫生—中医学]